If you’re young and healthy, but have a rotten or broken tooth that needs to be extracted, you might be better off today going for a dental implant instead of the bridge that used to be standard procedure. The main reason is that it is a more permanent solution, and greatly reduces the chances of having to go back under the dentist’s drill every few years.

“The success rate of an implant these days is 96 per cent over a period of 10 years, which means the chances of failure are almost negligible, whereas one out of three bridges will go bad in five years,” points out Santa Cruz based dentist Rajneesh Sethi. This also means implants may be cheaper in the long run, even though their initial cost usually works out two to three times that of bridges.

The success of implants has come from dramatic improvements in materials, techniques and facilities. “No other branch of dentistry has advanced as much as implants over the past decade,” says Dr Sethi.

Natural feel
An implant consists of a titanium screw that goes into the jaw bone. Capped with a false tooth and crown, it not only looks like a real tooth but also feels like one because pressure on the implant stimulates the underlying bone. The quality of the material used for the screw has improved along with the 3D imaging and machines available to fix it into the bone.

These developments, along with the growing band of people who can afford it in metros like Mumbai, are making implants the preferred option for those who need to replace missing teeth. “I do an average of 10-12 dental implants every month, which is significantly higher than what I used to do a year or two earlier.

The main reason is that in the dental implant procedure, the adjacent teeth remain unaffected,” says Kandivili-based dentist Amit Gupta.

That’s a compelling reason if you understand the composition and structure of teeth. When a bridge is used in place of a missing tooth, the adjacent teeth are also filed and crowned. “It means we use two teeth to support one false tooth, whereby putting pressure on the teeth structure,” explains Dr Sethi. “This is eliminated in a dental implant procedure where the false tooth is held in place by its titanium screw fixed to the underlying bone.”

“Dental implants have several advantages,” adds Dr Gupta. “Besides saving the adjacent teeth, the titanium fixtures used in dental implants give a more ‘natural’ feel to teeth and don’t give rise to any noticeable speech problems.”

Oral hygiene
Most important of all, implants can be brushed and flossed just like natural teeth, unlike bridges where the crowns on the adjacent teeth prevent proper cleaning of the gums and space between the teeth. This is why a number of bridges end up with infections, and have to be replaced.

Despite the advantages, however, dental implants are not for everyone. Since the titanium fixtures are implanted into the bone, elderly people with a weak bone structure may not be able to withstand them. “In extreme cases, the jaw can crack under the impact of drilling in the titanium screw. So care must be taken in deciding if a patient is suitable for a dental implant,” cautions Dr Sethi.

Diabetics too are usually discouraged because blood sugar can affect the integration of the implant with the bone. Poor oral hygiene is another contra-indication because of the likelihood of an infection developing in the implant.

For all these reasons, an implant is usually preceded by a battery of tests. “A bone volume analysis, CT scan and analysis of the nerve endings and those of the adjacent teeth are necessary, since inserting a dental implant requires precision,” says Dr Durgesh Aroor.

So, although any dentist can legitimately perform the procedure, it would be prudent to go to one who has built up a good reputation in implants.